| NPI | 1689314866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 62039) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 62039) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2026-07-15 |